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Cancer Metabolism as a Therapeutic Target: Metabolic Synthetic LethalityDrugs targeting different metabolic pathways induced in tumors may be used in combination with one another to induce synthetic lethality in cancer cells, while preserving the survival of normally proliferating cells.
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Erlotinib/Gemcitabine for First-Line Treatment of Locally Advanced or Metastatic Adenocarcinoma of the PancreasErlotinib (Tarceva) is a human epidermal growth factor receptor type 1/epidermal growth factor receptor (HER1/EGFR) tyrosine kinase inhibitor initially approved by the US Food and Drug Administration for the treatment of patients with locally advanced or metastatic non–small-cell lung cancer after failure of at least one prior chemotherapy regimen. In this report, we present the pivotal study that led to the approval of erlotinib in combination with gemcitabine (Gemzar) in patients with locally advanced/metastatic chemonaive pancreatic cancer patients. The combination demonstrated a statistically significant increase in overall survival accompanied by an increase in toxicity. Physicians and patients now have a new option for the treatment of locally advanced/metastatic adenocarcinoma of the pancreas.
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Commentary (Beart/Ortega): Role of Laparoscopic Techniques in Colorectal Cancer SurgeryThe authors have nicely reviewed many of the issues surrounding laparoscopic colon cancer surgery. However, we would like to offer a slightly different perspective on several points which they make.
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The Evolving Role of Multi-Gene Tests in Breast Cancer ManagementIf MGTs could predict which patients were most prone to late recurrence and thus might benefit from extended adjuvant endocrine therapy, it would be a huge advancement in the care and survivorship of our patients. More studies of MGTs are required to clarify their role in evaluating prognosis and predicting response to therapy in breast cancer.
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A Patient With Newly Diagnosed Metastatic Type 2 Papillary Renal Cell CarcinomaA 42-year-old man presented with increasing right hip pain that limited his ability to walk. Magnetic resonance imaging (MRI) revealed a right lytic acetabular lesion. Further work-up included a computed tomography (CT) scan, which revealed an 8-cm left kidney tumor.
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Exciting Developments in Relapsed/Refractory Multiple MyelomaThe panel concludes the discussion by offering future perspectives on the evolving treatment landscape in multiple myeloma, highlighting exciting developments and ongoing research.
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Should Men Diagnosed With Prostate Cancer Hit the Gym?Despite the clearly established overall health benefits of exercise, its role in reducing prostate cancer risk is unclear. Whereas some studies found often dramatic reductions in prostate cancer risk, others found no effect.
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Molecular Classification of Diffuse GliomasSignificant progress has been made in defining molecular signatures in diffuse gliomas. The clinically significant genetic alterations identified to date probably represent the tip of the iceberg, since new, potentially significant biomarkers are continuously described.
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Treatment of Pancreatic Cancer: Current Limitations, Future PossibilitiesIn an attempt to improve the grave prognosis associated with the diagnosis of pancreatic cancer, researchers have explored a number of novel therapies. These include hormonal therapy, immunotherapy, radiopharmaceuticals, and novel chemotherapeutic agents.
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Cost-Effectiveness of Genomic Testing for Colorectal Cancer: Are We There Yet?Although genomic testing can improve the cost-effectiveness of a treatment, assessing the cost-effectiveness of genomic testing outside the context of its impact on treatment is not practical.
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Intraoperative Radiotherapy for Breast Cancer: Its Perceived SimplicityWith many centers seeking to adopt IORT, there are licensing, proctoring, staffing, technical support, and reimbursement issues that need to be considered. We have reviewed the current international experience and describe one community cancer center’s experience with initiating an IORT breast cancer program.
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Prostate Cancer Risk Assessment ProgramProstate cancer is the most common form of cancer (except skin cancer) in men. Several factors have been associated with an increased risk for prostate cancer, including age, ethnicity, family history, lifestyle, and
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Management of Venous Thromboembolism in Cancer PatientsVenous thromboembolism is a common complication in patients with cancer. The management of deep-vein thrombosis and pulmonary embolism can be a considerable challenge in these patients. Diagnosing venous
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Dr. Ahmad Tarhini on Ipilimumab vs Interferon-α2b for Resected High-Risk MelanomaCancer Network spoke with Ahmad Tarhini, MD, PhD, about the results of the phase III United States Intergroup E1609 trial, presented at ASCO 2019.
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Proposed Algorithm for Managing Ibrutinib-Related Atrial FibrillationAlthough ibrutinib-related atrial fibrillation (IRAF) occurs in up to 11% of patients in clinical trials, these studies have rarely fully characterized bleeding events or risk factors for bleeding when ibrutinib is combined with anticoagulation. Furthermore, guidelines do not provide direction regarding the preferred anti-arrhythmic agent for IRAF.
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Irinotecan and Gemcitabine in Patients With Solid Tumors: Phase I TrialUsing a day 1 and 8, every-3-week schedule, our purpose was to determine the maximum tolerated dose of irinotecan (CPT-11, Camptosar) that can be administered immediately after gemcitabine (Gemzar) at a dose of 1,000 mg/m² IV. In this phase I trial, the maximum tolerated dose was defined as the dose level immediately below the level in which two of the first three patients in any cohort, or at least two of six patients in any expanded cohort, experienced dose-limiting toxicity. Dose-limiting toxicity pertained only to toxicity during the first cycle of treatment. Escalation of irinotecan was planned in groups of three patients, with three additional patients added at the first indication of dose-limiting toxicity. A total of 19 patients have been enrolled.
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Brain Metastases in Small Cell Lung CancerThe purpose of this paper is to provide an overview of the clinical presentation, diagnosis, and treatment of brain metastases in patients with SCLC, with a focus on current trends and developments in the treatment of this disease.
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Prophylaxis Against Fungal Infections and Cytomegalovirus Disease After Bone Marrow TransplantationAmong the serious complications associated with bone marrow transplantation are invasive fungal infections caused by organisms such as Candida and Aspergillus species and end-organ disease caused by
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At the Crossroads: The Intersection of the Internet and Clinical OncologyThe Internet is rapidly becoming a third party in the doctor-patient relationship. The World Wide Web, electronic mail (e-mail), and discussion groups have dramatically increased the quantity of medical and health
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Pemetrexed in Advanced Colorectal CancerPemetrexed (Alimta) shows single-agent activity in advancedcolorectal cancer. In two phase II studies in which patients receivedpemetrexed at 600 mg/m2 or 500 mg/m2 as first-line treatment for metastaticdisease, objective response rates were 15.4% and 17.2%.
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Strategies for Community Adoption of Bispecifics into Treatment of Relapsed/ Refractory Multiple MyelomaPanelists discuss effective strategies for promoting the adoption of bispecific antibodies in relapsed/refractory multiple myeloma (R/R MM) treatment, emphasizing the importance of educational initiatives, improving care transitions between academic and community settings, addressing misconceptions, and sharing key takeaways and clinical pearls for community oncologists.
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Gamma Knife Radiosurgery for 5 to 10 Brain Metastases: A Good Option for Upfront TreatmentThe aggressive management of brain metastases with SRS has supplanted radiation therapy in an effort to maintain patient quality of life in an era of advancing systemic cancer options.
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Neoadjuvant Chemoradiation for Rectal Cancer: Is More Better?Neoadjuvant chemoradiation has become the favored adjuvant treatment for stages II and III rectal cancer. Compared to postoperative chemoradiation, this modality of treatment has been shown to be superior in terms of toxicity, local relapse, and sphincter-saving.[1] This article will focus on the evolution of neoadjuvant chemotherapy over the past 2 decades, current acceptable neoadjuvant standards, and current investigational regimens.
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ACR Appropriateness Criteria® Management of Vaginal CancerThis article represents the consensus opinion of an expert panel and may be used to inform clinical recommendations in vaginal cancer management.
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Optimal Use of Bone-Targeted Agents in Breast CancerIt is quite obvious that bone morbidity has a negative impact on our patients with breast cancer. The use of bone-modifying agents in this setting can yield significant quality-of-life benefits.
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Osteoclast Inhibitors: A Multifaceted Tool in the Management of Breast CancerThere are still questions to be answered about the use of osteoclast inhibitors in the care of patients with breast cancer. The optimal duration and dosing schedule and how to improve treatment compliance are important issues to address.
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Clinical Management of EGFRI Dermatologic Toxicities: The Nursing PerspectiveAll nursing personnel actively participate in the nursing process, with the registered nurse taking primary responsibility. Five steps in the nursing process include assessment, diagnosis, planning, implementation, and evaluation. Health-care professionals have more than 10 years of experience with EGFR inhibitors in the oncology setting. To date, the application of the nursing process to assist in patient management has not been previously published or thoroughly described in the literature. This article will apply the nursing process utilizing current recommendations regarding the assessment and management of dermatologic toxicities associated with EGFR inhibitors.
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Synopsis of Angiogenesis Inhibitors in OncologyAngiogenesis is a dynamic process essential for primary tumor growth and metastases. New insights into the basic understanding of the biologic processes responsible for angiogenesis have led to the characterization of potential therapeutic targets. Several strategies for the development of antiangiogenic therapeutic modalities have been employed, including agents that (1) decrease the activity of specific angiogenic factors, (2) decrease the activity of endothelial survival factors, (3) increase the activity of naturally occurring antiangiogenic agents, or (4) indirectly downregulate angiogenic and survival factor activity.
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Ovarian CancerDespite the fact that it is highly curable if diagnosed early, ovarian cancer causes more mortality in American women each year than all other gynecologic malignancies combined.
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PET/CT in Prostate Cancer: An Unmet Clinical NeedMolecular imaging in prostate cancer can play the additional critical role of an early biomarker for response to therapy, similar to how 18F-FDG is used in other malignancies.
